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General NPI Number Information
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NPI Number | 1487883526
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Entity Type | Individual
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Provider Name | TIFFANY JOYCE BRILINSKI IDMT
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Gender | Female
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Dates
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Enumeration Date | 07/10/2009
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 301 N 1ST ST
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City | ALTUS AFB
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State | OK
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Zip | 73523-5005
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Country | US
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Telephone | 580-481-5230
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Fax |
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Provider Business Mailing Address
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Address Line | 1813 WHITE TAIL CIR
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City | ALTUS
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State | OK
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Zip | 73521-7806
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Country | US
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Telephone | 707-592-8357
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1710I1003X
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Taxonomy Name | Independent Duty Medical Technicians
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License Number |
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License Number State |
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